Nicholl J, Cole R P, Clarke J A
Department of Plastic and Reconstructive Surgery, Queen Mary's Hospital, Roehampton, London.
Ann R Coll Surg Engl. 1994 May;76(3):161-3.
A prospective study of emergency admissions to a regional plastic surgery unit was performed to investigate the extent and causes of delay between injury and operation. Details of 52 consecutive admissions, excluding those to the burns unit, were collected over a 50-day period. The mean delay between the injury and start of operation was 16.9 h (range 4.33-52.75 h). For patients referred from other hospitals in the region (n = 35) the mean delay between referral and admission was 3.64 h (range 0.5-17 h). This delay was 1.06 h (range 0-4.0 h) for those referred from the on-site accident and emergency department (n = 17). These results show that there is an excessive delay in treating these patients, but that transfer times to a regional centre contribute relatively little to the overall delay. The cause of this delay in the majority of cases was identified as lack of theatre availability. As a consequence of this 38% of operations took place after 2300 hours. If late-night operating was reduced, delay would worsen unless a second emergency theatre was made available between 1700 and 2300 hours, or emergency cases replaced elective ones on routine operating lists.
对一家地区整形外科单位的急诊入院情况进行了一项前瞻性研究，以调查受伤与手术之间延迟的程度及原因。在50天的时间里收集了52例连续入院患者的详细信息，不包括烧伤科的患者。受伤至手术开始的平均延迟时间为16.9小时（范围4.33 - 52.75小时）。对于从该地区其他医院转诊而来的患者（n = 35），转诊至入院的平均延迟时间为3.64小时（范围0.5 - 17小时）。对于从现场事故和急诊科转诊而来的患者（n = 17），这一延迟时间为1.06小时（范围0 - 4.0小时）。这些结果表明，治疗这些患者存在过度延迟，但转至地区中心的时间对总体延迟的影响相对较小。在大多数情况下，这种延迟的原因被确定为手术室可用时间不足。因此，38%的手术在23:00之后进行。如果减少夜间手术，延迟将会加剧，除非在17:00至23:00之间增设一间急诊手术室，或者在常规手术安排中将急诊病例替换择期病例。
